scholarly journals ASSESSMENT OF QUALITY OF RENDERING PALLIATIVE CARE TO THE ONCOLOGY PATIENTS

2017 ◽  
Vol 20 (7) ◽  
pp. 177-187
Author(s):  
E.P. Gladunova

The analysis of prevalence of cancer in the world, in Russia and on the territory of the Samara Region. The results of analysis of neglect of oncological diseases in the Samara region; the results of regression analysis of growth of oncological diseases are presented. The organization of rendering palliative care in the Samara Region is studied and assessment of provision of palliative patients with berths is carried out. The estimate of provision of patients with malignant neoplasms with drugs for pain management. Factors that reduce the quality of rendering of medical assistance to the oncology patients are revealed. Directions of improving the quality of pharmaceutical care of patients with cancer are suggested.

2017 ◽  
Vol 24 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Meda Sutkevičiūtė ◽  
Monika Stančiukaitė ◽  
Giedrė Bulotienė

Patients with oncological diseases, especially palliative care patients, suffer from physical and psychological difficulties. The quality of life of such patients is bad, they do not have purpose to live and they feel anxiety and distress. In 1959 Victor Frankl wrote the book Man’s Search for Meaning in which he stated that the driving force of human life lay in the ability to discern the  meaning of faith and spirituality. Inspired by Frankl’s ideas, the American psychiatrist William Breitbart with colleagues have developed both an individual and group model of Meaning-Centered Psychotherapy. Studies show that this therapy helps patients to cope with distress, to discover the  meaning of life in palliative care patients, and to find the  strength to look at life positively; also, it relieves the  symptoms of illness. The  Meaning-Centered Psychotherapy is integrated in various countries and has recently been initiated for palliative patients in Lithuania. The individual Meaning-Centered Psychotherapy was used in the case reviewed in this paper.


Author(s):  
Ekaterina Nikolayevna Pronina

We investigate the problem of legal support rights realization problems of the patients with oncopathology to palliative care. Palliative care in the legislation is defined as a set of medical interventions aimed at relieving from pain and other severe manifestations of the disease in order to improve the life quality of terminally ill citizens. The choice of the category of patients is due to the fact that malignant neoplasms are one of the main causes of death worldwide, they are the second cause of death in the Russian Federation. We analyze the current regulatory framework governing the provision of palliative care for cancer, establishing the rights of patients; were define the main problems of legislation implementation in this area, more specifically: the problems of staffing offices, departments and centers of palliative care, the need to create such a specialty as a doctor for palliative care, the problem of registration of obtaining narcotic analgesics for patients with oncological diseases and reporting on their use, the lack of specialized knowledge of doctors about schemes of anesthetization, the lack of information about routing in obtaining palliative care and information about the rights of patients.


2007 ◽  
Vol 116 (7) ◽  
pp. 502-513 ◽  
Author(s):  
Alfio Ferlito ◽  
Alessandra Rinaldo

Paraneoplastic syndromes may be the first sign of a malignancy. They are systemic, nonmetastatic manifestations associated with a variety of malignant neoplasms and occurring in a minority of cancer patients. These associations of symptoms and signs are not directly related to the site or local manifestations of a malignant tumor or its metastases, but their recognition may facilitate the detection of malignancies or recurrences. Paraneoplastic syndromes are categorized into 6 types: Dermatologic or cutaneous, endocrine, hematologic, neurologic, osteoarticular or rheumatologic, and ocular. Different oncotypes have rarely been associated with paraneoplastic syndromes in patients with cancer of the larynx and hypopharynx. The world literature has been reviewed.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24099-e24099
Author(s):  
Júlia Maria Mathias Pedreira de Freitas ◽  
Daniela Oliveira de Almeida ◽  
Luciana Castro G. Landeiro ◽  
Tércia Vilasboas Reis ◽  
Thomas Azevedo de Carmo ◽  
...  

e24099 Background: Medical cannabis (MC) emerged as an important complementary therapy in the context of oncological diseases. In 2019, the Brazilian Health Regulatory Agency (Anvisa) approved use of MC, which can be produced in the country and sold in pharmacies under medical prescription. Previous investigations have extensively correlated MC effectiveness, over management and support of symptoms caused by the disease and/ or its treatment. However, studies evaluating knowledge and patterns of MC use in oncology patients MC are lacking. In the present study, we assessed the perception of oncologists and palliative care physicians on MC as a complementary therapy for cancer patients, and their personal experiences in clinical practice in Brazil. Methods: In October 2020 an online survey was sent via e-mail by the Brazilian Society of Clinical Oncology and the National Academy of Palliative Care for physicians with expertise in oncology and/or palliative care. Outcomes measured included knowledge and opinions about MC, prescription experience and impressions about the Brazilian legislation. Data analysis was performed with descriptive statistics, comparison tests and the Poisson regression model with robust variance, using the IBM Statistical Package for the Social Sciences software, version 25. Results: A total of 124 physician participated in the study and, of those, 58.1% were oncologists, and 82.3% believed that MC has application as a complementary therapy in cancer. In contrast, only 52.4% of the participants felt comfortable recommending its use and only 15.3% have ever prescribed MC for their patients with cancer. Further, among those who have never prescribed, 71% have already referred patients to other professionals to prescribe, and 61% indicated lack of knowledge as the main factor for not prescribing. In addition, more than half of participants claimed not knowing Brazilian legislation regarding MC use. Nausea and vomiting were mentioned by 73.4% of physicians as the major indication for MC. Conclusions: Oncologists and palliative care physicians agree with the applicability of MC use for the management of symptoms related with or caused by cancer. However, our findings infer that factors such as lack of knowledge, legislation barriers and lack of robust scientific evidence, lead to its limited use among Brazilian oncologists and palliative care physicians.


2021 ◽  
Vol 66 (1) ◽  
pp. 44-48
Author(s):  
I. Galstyan ◽  
M. Konchalovsky ◽  
M. Kozlova ◽  
V. Nugis

Purpose: On clinical examples to estimate a probable contribution of the postponed earlier external radiation of all body in the doses exceeding 1 Gy at development of multiple malignant neoplasms of different localization and a leukaemia. Material and methods: At 8 of 164 patients, it is long observed after the postponed acute radiation syndrome (ARS), multiple oncological diseases are revealed. Dynamics of consecutive forming of solid tumors at 2 patients and also malignant neoplasms and a myelodysplastic syndrome (MDS) with transformation in an acute leukamia at 1 patient is tracked. Observation duration – 31 years, 43 years and 32 years. Results: Availability of medical care to the patients who transferred ARS and high quality of its rendering at all stages (out-patient, stationary) allowed to reveal malignant neoplasms at early stages of development and to achieve an absolute recovery. However eventually at these patients development and other oncological diseases was observed. The given clinical observations allow to assume that at presented cases radiation acted on various stages of carcinogenesis, and its contribution to development of different oncological diseases in all patients was not identical. Conclusion: The analysis of clinical observations allows to assume that radiation contribution to genesis of various oncological diseases at the persons which underwent radiation in the doses causing development of ARS is various. Now in our country there are no approaches to quantitative assessment of a contribution of radiation effects to development of malignant neoplasms in each case. The patients who underwent acute single exposition in doses over 1 Gy have to be considered as having predisposition to development of multiple tumors in the remote terms. In this regard they for life need medical follow up for the purpose of early diagnostics and adequate treatment of the developing malignant neoplasms.


2021 ◽  
pp. 861-871
Author(s):  
Tarun Sabharwal ◽  
Nicos I. Fotiadis ◽  
Andy Adam

Interventional radiology uses image guidance to perform minimally invasive therapeutic and diagnostic procedures. It is an integral part of the multidisciplinary team managing patients with cancer. Interventional radiology is involved in all stages of the cancer patient’s journey starting from performing image-guided biopsies for the diagnosis of cancer, venous access procedures, and therapeutic procedures, and focuses on the palliation of symptoms and improvement in the quality of life. All interventional procedures carry some risk, which is related to the underlying condition, the nature of the procedure, and the experience of the radiologist. Therefore, it is important in patients with advanced malignant disease receiving palliative care to contemplate only those procedures that will alleviate symptoms, and in which the potential benefits outweigh the risks. This chapter presents the drainage, stenting, feeding, embolization, ablation, and supportive interventional radiology procedures which could potentially benefit patients undergoing palliative care. The focus will be on the indications, contraindications, and likely outcomes, rather than on detailed technical descriptions.


2019 ◽  
pp. bmjspcare-2019-001880 ◽  
Author(s):  
Maiken Bang Hansen ◽  
Lone Ross ◽  
Morten Aagaard Petersen ◽  
Mogens Groenvold

BackgroundPatients referred to specialised palliative care are troubled by symptoms/problems, but more knowledge is needed on the level and frequency of symptoms/problems. It is also uncertain how gender, age and cancer diagnosis, respectively, are associated with symptoms/problems.AimsTo describe symptoms/problems in patients with cancer at the start of specialised palliative care, and to study how age, gender and cancer diagnosis were associated with symptoms/problems.DesignA register-based study including data from the Danish Palliative Care Database.Setting/ParticipantsPatients with cancer who reported their symptoms/problems using the European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care (EORTC QLQ-C15-PAL) at the start of specialised palliative care were included. Ordinal logistic regression was performed to test if gender, age and cancer diagnosis were associated with each symptom/problem.Results31 771 patients with cancer were included in the study. The most prevalent and severe symptoms/problems were pain, appetite loss, fatigue, poor physical function and poor quality of life. Gender, age and cancer diagnosis were significantly associated with most symptoms/problems. The strongest associations between symptoms/problems and gender and age, respectively, were increased risk of nausea in women, as well as increased risk of poor physical function and reduced risk of sleeplessness and pain with increasing age. Patients with brain/central nervous system cancer had the lowest risk of symptoms but the highest risk of poor physical function.ConclusionAt the start of specialised palliative care, patients with cancer experience severe levels of symptoms, poor physical function and poor quality of life. Age, gender and diagnosis were significantly associated with most symptoms/problems, but the strength and direction of the associations differed across symptoms/problems.


2015 ◽  
Vol 9 (1) ◽  
pp. e16-e16 ◽  
Author(s):  
Mathilde Ledoux ◽  
Wadih Rhondali ◽  
Véronique Lafumas ◽  
Julien Berthiller ◽  
Marion Teissere ◽  
...  

BackgroundPalliative care (PC) improves the quality of life of patients with advanced cancer. Our aim was to describe PC referral among patients with advanced cancer, and associated outcomes in an academic medical centre.MethodsWe reviewed the medical records of 536 inpatients with cancer who had died in 2010. Our retrospective study compared patients who accessed PC services with those who did not. Statistical analysis was conducted using non-parametric tests due to non-normal distribution. We also conducted a multivariate analysis using a logistic regression model including age, gender, type of cancer and metastatic status.ResultsOut of 536 patients, 239 (45%) had PC referral. The most common cancer types were respiratory (22%) and gastrointestinal (19%). Patients with breast cancer (OR 23.76; CI 6.12 to 92.18) and gynaecological cancer (OR 7.64; CI 2.61 to 22.35) had greater PC access than patients with respiratory or haematological cancer. Patients referred to PC had significantly less chemotherapy in the last 2 weeks of life than non-referred patients, with 22 patients (9%) vs 59 (19%; p<0.001). PC-referred patients had significantly fewer admissions to intensive care units in the last month of life than non-referred patients, with 14 (6%) vs 58 (20%; p<0.001).ConclusionsThere was a large variation in access to PC according to the type of cancer. There is a need to improve collaboration between the PC service and the respiratory, cancer and haematology specialists. Further research will be required to determine the modality and the impact of this collaboration.


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